Viral hepatitis during pregnancy

Objective: A great degree of controversy prevails over the existing reports on the severity and outcome of acute viral hepatitis (AVH) during pregnanc y. The present study describes the outcome of AVH associated with pregnancy . A correlation was also assessed for gestation period, viral etiology and outcome of AVH. Method: The serum samples of 273 females with viral hepatit is (age group 18-23 years) were included in the study. Among them, 127 fema les were pregnant and 146 were non-pregnant cases (as a control group). The sera were screened for seromarkers of the hepatitis A virus (HAV) through to the hepatitis E virus (HEV) by the latest available generation ELISA kit s. Among the 127 pregnant females, 83 were AVH cases, while 44 were fulmina nt hepatic failure (FHF) cases. Among the 146 non-pregnant females, 129 wer e AVH and 17 were FHF cases. Result: Among the AVH pregnant females, 73 (57 .5%) had HEV infection. Fifty-eight percent of the HEV infected pregnant fe males were associated with FHF. Among non-pregnant females HEV was document ed in 67 (46%) cases. HBV infection was observed in 19% and 18% of the preg nant and non-pregnant females, respectively. Twenty percent of the pregnant and 33% of the non-pregnant females remained non-reactive for seromarkers of HAV-HEV. The mortality rate was highest (56%) among HEV infected FHF cas es during third trimester of pregnancy. The chi (2) test was applied to che ck the statistical significance for the differences over the prevalence in various groups. Conclusion: In the present study, HEV was found to be the c hief etiological agent, associated with higher morbidity and mortality. How ever, the incidence of HEV in pregnant females was not significantly differ ent from non-pregnant females. The prevalence of HAV, HCV and HDV were very low in the study. An increased incidence of FHF was noted among HEV infect ed pregnant females, while infection with an agent other than A-E was commo nly associated with FHF among non-pregnant females. (C) 2001 International Federation of Gynecology and Obstetrics. Al rights reserved.